Patients enrolled in the study will be randomized to either total parathyroidectomy with transplantation of a portion of parathyroid tissue to forearm, or removal of 3 1/2 parathyroid glands leaving a portion of one gland in the neck. The results of the two treatments (incidence of hypoparathyroidism, recurrent hyperparathyroidism, hospital stay, time of dependence on replacement calcium/vitamin D, etc.) will be compared.